With the advancement of digital technology, the healthcare industry is expected to keep up. When prescriptions are keyed on screens rather than penned, fitting in becomes a challenge for the technophobe physicians who risk being phased out of this digital lap.

For 84-year-old physician, Anna Konopka, reality hit hard when she could not participate in New Hampshire’s new mandatory system for reporting opioid prescriptions, in an effort to reduce overdoses. Realising that she was an instant loser in this game of clicks, she surrendered her licence to practise – to avoid suspension from the New Hampshire Board of Medicine.

Konopka’s three-room office is simple, devoid of any hint of modern technology. One sees not a flat screen, but a landline telephone and a fax machine in the cottage. She keeps her patient records, all handwritten, in the filing cabinets and she has no receptionist or nurse.

The state previously challenged Dr Anna Konopka’s record keeping, prescribing practices and medical decision-making. It said her limited computer literacy was a hindrance.

Providing patient rapport in place of digital knowledge

Dr Anna Konopka, 84, looks through her appointment book in her office next to her home in New London, NH. Photo credit: Cheryl Senter/STAT
Dr Anna Konopka, 84, looks through her appointment book in her office next to her home in New London, NH. Photo credit: Cheryl Senter/STAT

Despite hitting the ultimate low in digital grades, the veteran doctor has garnered scores of fans in the rural town of New London with a population of 4,000.

She is a doctor par excellence, one who would never turn her patients away, and according to her patients, most of whom are uninsured, she would treat anyone who could fork out just USD50.

Despite her struggle with computers, Konopka is not a quitter.

Adamant to get her licence back, the defiant physician said, “I’m not upset about anything. The legal system is a game. You move. They move. It’s full of tricks and different movements.”

“I am fighting. Therefore, as long as I am fighting, I have some hope,” she added.

Some of Konopka’s patients have not moved on with other primary care providers, and 30 of them have written to the court to reconsider its ruling.

Cheryl Hodgdon, a 56-year-old dog trainer from Croydon, who consulted Konopka once a month, said, “She’s different. She’s on her own. She’s not controlled by any hospital; she can talk to you for as long as you need her to.”

“Electronic medicine” could compromise healthcare outcomes

For the passionate doctor, healthcare entails more than keeping up with technology. The concept of “electronic medicine” is a bad idea to Konopka who feels that in hastening the switch to digital records, patient care has been compromised.

“You are with the system, or you are out of the system,” she said. “It’s like communism: If you are out of the system you are treated as an enemy... I am practicing traditional medical arts. They manage the patient and I treat the patient. I’m not going to compromise.”

Determined not to retire yet, Konopka suspected it might be her age that led to the board’s disciplinary actions. “They got the idea that I am old enough to be forced to retire,” she said. “But I don’t want to retire. It doesn’t matter my chronological age: I can work right now for another 10 years.”

Inevitably, Konopka has become the face of a related debate about how best to ensure that older doctors are providing the most up-to-date care.

Konopka speaks in her own defense during the 3 November 2017 court hearing seeking an injunction to get back her medical license. Photo credit: Geoff Forester/STAT
Konopka speaks in her own defense during the 3 November 2017 court hearing seeking an injunction to get back her medical license. Photo credit: Geoff Forester/STAT

“This is one of the big questions in the field of medical education: What should we be requiring of older doctors in terms of demonstrating the maintenance of the skill required to practice medicine?” said Dr Anupam Jena, a health economist at Harvard and a physician at Massachusetts General Hospital.

Keeping patient-doctor interactions human

In a 2007, UK General Medical Council (GMC) hearing, Dr Satya Das who has practised for 45 years, blamed his ignorance of computers for his failure to keep proper patient and prescription records.

"I didn't like computers. I was not computer literate and I was misled,” he said.

Yet, other health experts argue that – with the enormous amount of information that health providers are expected to have at their fingertips – technology would help to produce fast and accurate scans, lab reports, billings and research.

In a research by the University of California, San Francisco, researchers analysed data from patient-doctor interactions between 2011 and 2013.

Doctors who spent less time clicking on the screen were reported to have achieved excellent patient satisfaction ratings as high as 80% compared to those who relied heavily on computers. The researchers noted that with the use of digital technology, there was less patient rapport.

So, as the digital race powers on, the link between age and one’s computer literacy skills remains hazy. Would the power of the click surpass the finesse of human touch in healthcare?

For those who are left behind by these digital waves, would they be shown the door regardless of how passionate and competent they might have been? MIMS

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